Claim.MD Clearinghouse Review

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Claim.MD has been a leading EDI clearinghouse for more than 40 years, processing tens of millions of transactions every month. The web-based medical claims clearinghouse manages every aspect of the revenue cycle including claims management, eligibility, and electronic remittance advice (ERAs). This system is compatible with almost all billing systems and makes even older billing software 5010 compliant.

With Claim.MD, providers enjoy increased cash flow by streamlining their electronic transactions. This not only provides complete control over claims from filing to payment, it reduces costly staff time to research and correct rejected claims. When claim follow-up with a payer is necessary, Claim.MD simplifies the process with a complete and readable Claim History that can be printed for proof of timely filing. And when claims are rejected, that’s when Claim.MD really shines – managing the return process, speeding payment, and eliminating the confusion of re-billing.

• Claim Management Tool

“We’ve never seen an easier claim management system; the unique claim management tools in this clearinghouse identify claims that need corrections, allow you to fix them online in real time, and even identify the most likely causes of payer rejections.”

• ERA

Electronic Remittance Advice tools let you easily download ERA in spreadsheet form and PDF. Remits are archived for several years so users always have access to them.

• Eligibilty

Real-time eligibility is available for hundreds of payers.

• Easy Appeal Tool

From any claim you can download, a PDF-appeal packet is created with everything you need for an appeal. Includes CMS-1500, UB form, complete claim history, remittance advice, and appeal request form.

• Excellent Support

Support is requested online with a single click from any claim, but phone support is also available. Claim.MD has been in the business for more than 30 years and providers love the support they receive.

• Fastest Claim Transmits

Many clearinghouses don’t actually send your claims to the payer until that evening or the next day. But with Claim.MD, payers acknowledge receiving claims in just a few minutes. This is the closest thing to true real-time claims in the industry.

• Secure

Claim.MD ensures safe and secure transactions between providers and payers through EHNAC accreditation, CAQH CORE certification and SOC 2 certification.

• Pricing

Learn more about Claim.MD’s pricing here.